In this Dartmouth Atlas report, the fourth in a series of nine U.S. regional reports, the Great Lakes region (Illinois, Indiana, Michigan, Ohio, and Wisconsin) is highlighted. The report shows the wide regional variation in the likelihood that patients with similar conditions receive elective procedures.

For patients whose conditions can be treated with elective surgery, location matters. For example, if you have heart disease and live in Muskegon, Michigan, you are half as likely to undergo balloon angioplasty than if you live in Decatur, Illinois, and more than three times as likely to undergo back surgery than if you live in Cleveland. If you have osteoarthritis of the knee and live in Port Huron, Michigan, you are twice as likely to have your knee replaced than if you live in Chicago.

This report, a collaborative project with the Informed Medical Decisions Foundation, looks at the variation in surgical rates in 306 hospital referral regions across the United States (a hospital referral region is a large health care market containing at least one referral hospital).